| NPI | 1881792661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ANTHONY CLARK Chairman 804-347-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101032223) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2009-01-08 |